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Geburtshilfe und Frauenheilkunde, 1996
Zusamme nfassu ng: 212 Pa tientinnen mit Adn ext um o ren w urden präopera tiv tr a nsvag inal so... more Zusamme nfassu ng: 212 Pa tientinnen mit Adn ext um o ren w urden präopera tiv tr a nsvag inal so no mo rpho log isch und farbdopp lersonog raph isch unte rsu cht: 81 präme nopausal (13 matlgne, 68 benigne Tumore n) und 131 postm enopausal (55.7 6). Entsprechend ihr er Sonomorphologie w urden die Tumore n den Scores I-V nac h Schillinger [16) zugeordnet. Die Scores I und 11 erfasse n be nig ne u nd d er Score V mal igne Tum oren re lativ zuverlässig. In den Scores 11I un d IV sind insbesond ere prämenopau sal be nigne und ma lign e Tum oren verteilt. Mit der Zuordnung Score I und 11 ben igne bzw. III-V maligne we rde n die Tumore n prä-und postmenopausal mit einer hohen Se nsitivität (> 90 %) aber mit eine r geri ng en Spezl fltät (56 % bzw. 70 %) dif• feren ziert. Die Tumoren der Scores 11I und IV w urden da her farbdopplerso nog rap hisch zusätzlich ana lysiert d urch d ie Kriterie n: nied rigster Resista nce Index (Rlmin), Zahl der Tumorarterie n (ART), höch st e ma ximale systolische Flußg eschwindigkeit (Smax) und die Sum me d er maxima len systo lische n Geschwindigk eit en aller Tumo ra rt erie n (Ssum). Alle Param e te r unterschied en sich signifikant für die benign en und malig nen Turneren prä-und postmen o pausal. Dami t konnt en die Tumo re n d er Scores III und IV pr äme nop ause l mit e ine r Treffsicher heit von 66 %-81% und po stmen op ausal mit eine r Treffsicherh eit von 69 %-86 % d iffe re nzie rt we rd en. Die kombinierte Beurteilun g mit der farbd op pler son ogra phischen Differ en zierung von Sco re 11I und IV e rreichte eine Treffsicherheit zw ische n 84 % und 90 % mit e iner ma ximal en Se nsitivität vo n 92 % prä-und von 89 % pc stm enopausal. Diese sequentiell kombinierte Farbdoppler sonog raphie e rg änzt und verbessert für so no morp ho logisc h nicht siche r zuzuo rd ne nde Tumoren die Tumordifferen zierung. Durch d ie Beschr änk ung de r Farbdoppler son ographi e a uf die Scor es 11I und IV (42 % der Tumoren) kann der Zeitaufwand für die Untersuch ung reduziert we rd en. (omblned Examination of Ovarlan Tumours by Tra nsvagina l Sonomorphology and (olour Doppler So nographie: Tran svag inal so nomo rp holog ie a nd colour Dop pler meas urements were o btatne d preo pe rat ively in 212 ad nexa l tumou rs: 81 prem en op au sal tumours (13 malign ant an d 68 benign) and 131 postmen op au sa l t umou rs (55 vs 76). Tumours were d ivided int o Iive d iffer ent sccre s aceor ding to their so nomo rpho logy [16]. Scores l a nd 11 a re relat ed to beni gn turnou rs. Score V repre sents typically maligna nt tum o urs. Scores 11I and IV are esseclated w ith benign end maligna nt tumou rs. If sco re l and 11 are co nsfder ed as benign and sco re 11I to V as ma ligna nt the se nst
Geburtshilfe und Frauenheilkunde, 1999
Informationen über die Infiltrationstiefe des Endometriumkarzinoms als Prognosefaktor sind für di... more Informationen über die Infiltrationstiefe des Endometriumkarzinoms als Prognosefaktor sind für die Operationsplanung wünschenswert. Die Wertigkeit der transvaginalsonographischen Bestimmung der Infiltrationstiefe beim Endometriumkarzinom wird bestimmt. Material und Methodik: 214 Patientinnen mit Endometriumkarzinom (118 Pat. vor und 96 andere Pat. nach Curettage) wurden vor der Hysterektomie untersucht. Sonographisch wurde die doppelte Endometriumdicke (E) a.p. und der Uterusdurchmesser (U) a.p. im Fundus bestimmt, und der Quotient E/U berechnet. Eine oberflächliche Infiltration des Myometriums (< = 50%) wurde bei E/U < = 0,5, eine tiefe Infiltration (> 50%) wurde bei E/U > 0,5 angenommen. Die sonographischen und die histologischen Befunde wurden verglichen. Ergebnisse: Die tiefe Myometriuminfiltration wurde mit einer Sensitivität von 92% und mit einem pos. Vorhersagewert von 74 % erfaßt. In 13 % wurde die Infiltrationstiefe vornehmlich wegen exophytischen Tumorwachstums überschätzt und in 3% unterschätzt. Die diagnostische Treffsicherheit mit 83% bzw. 85% war für beide Gruppen-vor und nach fraktionierter Abrasiogleichwertig. Schlußfolgerung: Mit weiteren Befunden wie histologischer Typ, Grading, Ploidiegrad und Rezeptorstatus unterstützt die sonographische Beurteilung der Infiltrationstiefe die Operationsplanung beim Endometriumkarzinom.
Geburtshilfe und Frauenheilkunde, 1997
Purpose: Due to their sonomorphical appearance mature cystic teratomas are often correctly diagno... more Purpose: Due to their sonomorphical appearance mature cystic teratomas are often correctly diagnosed ,,at first sight. However the complex and variable architecture of the lesions frequently leads to their classification as malignant if sonographic tumour scores are applied. Material and Methods: In the Department of Gynaecology Hospital at the University of Freiburg, we performed between 1988 and 1996 a preoperative ultrasound examination of 117 cystic teratomas in 110 patients. In 63 of these tumours Colour-Doppler sonography was also used. Results: As typical sonographic markers for the diagnosis of cystic teratomas was used the following criteria: a line pattern in the fluid phase of the tumour (seen in 62 [53%] cases); homogeneous echogenic structure (seen in 102 [82%] cases); shadowing (seen in 50 [43%] cases). 96% of the tumours showed at least one of these markers. In 62% of dermoid plugs with hairs typical sonographic criteria were present. In 25% of the cases with osseous or dental structures characteristics shadowing was observed. The ranking of the sonographic diagnosis was assessed for 754 ovarian tumours including 71 cystic teratomas. The dermoid tumours were predicted with a sensitivity of 94.3%, a specificity of 99.3%, an accuracy of 98.8% and a positive or negative predictive value of 93% and 99.3%, respectively. Using the colour Doppler technique we were able to predict the tumour status of the complex cystic teratomas correctly in 91% and 93% of the cases, respectively, using one of the following parameters: number of tumour arteries, maximum systolic velocity or sum of maximum systolic velocities. This figure dropped to 68% if minimal resistance index was used. Conclusion: Basing on typical markers, sonographic diagnosis of cystic teratomas is very reliable. Colour Doppler sonography is a useful, independent method to supplement determination of the tumour status of teratomas.
Ultraschall in der Medizin - European Journal of Ultrasound, 2008
Phantomuntersuchungen von Ultraschallqeraten zur Qualitats-verbesserung in der Mammadiagnostik Zu... more Phantomuntersuchungen von Ultraschallqeraten zur Qualitats-verbesserung in der Mammadiagnostik Zusammenfassung: Ziel: Fur die Brustd iagnostik schreibt die Gerateverordnunq de r kassenarztllchen Bund esv ereinigung die Verwendung von Schallkopfen mit einem Frequenzbereich von 5-7,5 MHz, eine Bildfeldbreit e von mindes t ens 5 cm und e inen Arbeitsb erei ch zwischen D,S und 4 cm vor. Dies laBt die Verwendung von Ultraschallqeraten zu, mit denen keine gute Brustdiagnostik rnoqllch ist , und sch llefst die Anwendung von hochauflosenden Ultrasch allqeraten mit nur 4 cm breite n Schallkopfen a us. Mit dem Ziel einer rnoqlichst objektiven Oberprufunq der Cera t e d urch sta ndar disierte Phantomuntersuchungen wurde die vorlieg ende Studie durchgefUhrt. Methode: Sechzehn Ultraschallqerate verschiedener Preiskategorien wurden qepruft, Mit alle n Geraten wu rden nach einem festgelegten Protokoll standardisierte Einstellungen an ein em Phantom (Modell 550, ATS Laboratories, Bridgeport, USA) durchgefuhrt, Beurteilt wu rde der Kontrastumfang sowie die Auflosunq in ve rschied en en Untersuchungstiefen bei lysten von 1-4 mm Durchmesser und Drahtphantomen mit definierten Abstanden von 0,5-3 mm. Ergebnisse: Die Bew ertu ng der Bilder durch 4 Untersucher zeigt e einen deutlichen lusammenhang zwischen Auflosunq und Kontrastumfang mit de r Preiskategorie. [edoch zeigten sich auch innerhalb jede r Preiskategorie groBe Unterschiede. SchluRfolgerung: Da ein e Qualitatskontrolle durch Vorgaben de r Frequenz und der Bildgeometrie nicht moqlich ist, kann e ine Verbes serung der Ultraschalldiagnostik nur durch Phantom untersuchungen sichergestellt werd en. schlusselworten Mammasonographie-Qualitatskontrolle-Testphantom-Brustkrebs Comparison of Breast Ultrasound Equipment with a Quality Assurance Phantom: Aim: According to th e Germa n guidelines for quality control of ultrasonic equipment, the following conditions are required for breast ultrasound : A t ransduce r frequency between 5-7.5 MHz and a minimum field of view of 5 ern, Satisfacto ry images must be obtained in a depth between 0.5 and 4 cm with a wide tolerance of the focal zones. This allows the use of poor quality equipment which does not produce a satisfactory image quality and it excludes a number of high frequency and high resolution transducers with a field of view below 5 cm. This study with a test phantom was pe rformed to define image quality objectively. Method: Sixteen ultr asound instruments in different price categories were used to perform standardized examinations on a breast phantom mod
Geburtshilfe und Frauenheilkunde, 1994
In 129 patients with ovarian tumours, a preoperative examination by transvaginal colour Doppler s... more In 129 patients with ovarian tumours, a preoperative examination by transvaginal colour Doppler sonography (ATL UM9 HDI) was performed. 45 were malignant and 84 benign. 46 patients were premenopausal and 83 postmenopausal. All tumour vessels were analysed by spectrum analysis. The number of tumour vessels and the lowest resistance index (RImin) and pulsatility index (PImin) of all vessels were evaluated as diagnostic criteria of the neovascularisation. Up to 19 vessels were found in 115 (89%) tumours. In benign lesions, the number of vessels was significantly lower than in malignancies (median 3 versus 9, p < 0.0001). The RImin and PImin values between benign and malignant tumours were also significantly different, independent of the menopausal status. In postmenopausal patients, the median RImin in 42 benign tumours was 0.62 (0.26-1.0) and in 41 malignancies 0.40 (0.22-0.66). The median PImin was 0.98 (0.31-5.84) in benign tumours and 0.53 (0.25-1.22) in malignant tumours. Howev...
Prostaglandins, 1984
Prostaglandin E2 (PGE2) seems to stimulate cAMP accumulation in ovaries of all mammals. While it ... more Prostaglandin E2 (PGE2) seems to stimulate cAMP accumulation in ovaries of all mammals. While it acts through specific receptors in some species, our earlier observations (1) suggest absence of PGE2 receptors in the rat ovary. In order to further substantiate this assumption we digested ovarian membranes from the bovine and the rat with various enzymes and measured cAMP after stimulation with PGE2, NaF, and hCG. Pronase, trypsin, and phospholipase C abolished cAMP accumulation completely. Neuraminidase, beta-galactosidase and phospholipase D did not interfere with cAMP formation. After treatment with phospholipase A2, PGE2-mediated cAMP accumulation was abolished in the bovine but not in the rat ovary. Formation of cAMP disappeared after hCG but not after NaF in both species. Furthermore specific binding of PGE2 could not be demonstrated in phospholipase A2-treated bovine ovaries. These findings are consistent with presence of specific PGE2 receptors in the bovine and their absence in the rat ovary.
Ultrasound in Obstetrics & Gynecology, 1994
Color Doppler and Duplex measurements were obtained in 83 (42 benign, 41 malignant) ovarian tumor... more Color Doppler and Duplex measurements were obtained in 83 (42 benign, 41 malignant) ovarian tumors in postmenopausal patients. An ATL UM9/HDI was used. The following flow criteria were analyzed: lowest resistance index (RI) and pulsatility index (PI), total number of arteries and number of central arteries and the maximum, mean and sum of systolic, end-diastolic and time-averaged maximum velocities of all intratumoral vessels. In 98% of malignant and in 85% of benign lesions, vessels were detected. All flow criteria showed highly significant differences between benign and malignant tumors (p < 0.0001). However, there was a considerable overlap between benign and malignant tumors (e.g. the median of the lowest RI was 0.62 (range 0.26-1.0) for benign and 0.40 (0.22-0.66) for malignant tumors; the median of the maximum systolic velocity was 17.5 cm/s (range 5.2-61.5 cm/s) for benign and 47.05 cm/s (14.6-105.0 cm/s) for malignant tumors). Differentiation of malignant tumors by the lowest RI and PI, number of arteries and maximum of systolic flow velocities gave a sensitivity of 77-85%, specificity of 77-83% and accuracy of 80-84%. Differentiation was superior by calculation of the maximum end-diastolic velocities and by the summation of the systolic, end-diastolic and time-averaged maximum flow velocities: sensitivity 90-9.5% specificity 83-86% and accuracy 87-91%. This study confirms that a single measurement is not sufficient for an accurate differentiation of ovarian lesions and, besides the measurement of minimum RI and PI, the measurements of flow velocities as Doppler criteria play an important role.
International Journal of Gynecology & Obstetrics, 1997
Hormone Research, 1991
A full-term 46,XY female newborn presented with respiratory failure due to a right-sided diaphrag... more A full-term 46,XY female newborn presented with respiratory failure due to a right-sided diaphragmatic hernia. During surgical repair, exploration revealed isolated dextrocardia and hypoplasia of the right lung. Neither gonads nor wolffian or müllerian structures could be palpated. Cardiac catheterization demonstrated defects of the ventricular septum, hypoplasia of the right pulmonary artery, persistence of the left vena cava superior and a patent ductus arteriosus. Anthropometric data were normal at birth, but fell below the 3rd percentile during follow-up. Body proportions displayed a predominance of the upper compared to the lower segment. Endocrine studies indicated no defect of steroid biosynthesis and no functional gonadal tissue. Using genetic analyses of various loci within the testis-determining region of the Y chromosome, a mutation could not be detected. The patient died from pneumonia at the age of 19 months. Postmortem examination confirmed the diagnosis of gonadal agenesis.
Differentiation, 1987
The testicular and ovarian protein patterns of prepubertal rats were studied by two-dimensional g... more The testicular and ovarian protein patterns of prepubertal rats were studied by two-dimensional gel electrophoresis after both in vivo and in vitro translation. Analysis of the approximately 750 polypeptide spots detectable in gonadal extracts (in vivo translated polypeptides) revealed 14 testis-specific, and 2 ovary-specific spots. Conversely, only 4 testis- and 2 ovary-specific polypeptide spots (of a total of about 600) were detected after in vitro translation of the respective polyadenylated RNAs using the reticulocyte lysate system. Simultaneous in vitro translation plus microsome-mediated cotranslational modification increased the number (of testicular spots to 8, and of ovarian spots to 3 (of a total of 600). The polypeptides synthesized in vitro were well comparable with respect to molecular weight and isoelectric point to those synthesized in vivo. Therefore, testicular polypeptide diversity is mainly the result of co/posttranslational modifications. Many of these proteins appeared to be glycosylated as indicated by their specific binding to Concanavalin A. The system used demonstrates that co/posttranslational modifications play a role in the establishment of polypeptide and thus organ diversity.
Acta Obstetricia et Gynecologica Scandinavica, 1994
Human Genetics, 1988
Poly(A)+ RNAs from male and female gonads of 20-day-old rats were translated in vitro using rabbi... more Poly(A)+ RNAs from male and female gonads of 20-day-old rats were translated in vitro using rabbit reticulocyte lysates. The resulting polypeptides were incubated with specific anti-male (anti-H-Y) antisera raised in female rats by intrasplenic immunization with syngeneic male skin. Using a second antibody, a male-specific polypeptide of molecular weight approximately 18,000 was immunoprecipitated. This male-specific polypeptide was not cotranslationally modified in vitro and appeared to be identical to serological H-Y antigen.
Geburtshilfe und Frauenheilkunde, 1996
Zusamme nfassu ng: 212 Pa tientinnen mit Adn ext um o ren w urden präopera tiv tr a nsvag inal so... more Zusamme nfassu ng: 212 Pa tientinnen mit Adn ext um o ren w urden präopera tiv tr a nsvag inal so no mo rpho log isch und farbdopp lersonog raph isch unte rsu cht: 81 präme nopausal (13 matlgne, 68 benigne Tumore n) und 131 postm enopausal (55.7 6). Entsprechend ihr er Sonomorphologie w urden die Tumore n den Scores I-V nac h Schillinger [16) zugeordnet. Die Scores I und 11 erfasse n be nig ne u nd d er Score V mal igne Tum oren re lativ zuverlässig. In den Scores 11I un d IV sind insbesond ere prämenopau sal be nigne und ma lign e Tum oren verteilt. Mit der Zuordnung Score I und 11 ben igne bzw. III-V maligne we rde n die Tumore n prä-und postmenopausal mit einer hohen Se nsitivität (> 90 %) aber mit eine r geri ng en Spezl fltät (56 % bzw. 70 %) dif• feren ziert. Die Tumoren der Scores 11I und IV w urden da her farbdopplerso nog rap hisch zusätzlich ana lysiert d urch d ie Kriterie n: nied rigster Resista nce Index (Rlmin), Zahl der Tumorarterie n (ART), höch st e ma ximale systolische Flußg eschwindigkeit (Smax) und die Sum me d er maxima len systo lische n Geschwindigk eit en aller Tumo ra rt erie n (Ssum). Alle Param e te r unterschied en sich signifikant für die benign en und malig nen Turneren prä-und postmen o pausal. Dami t konnt en die Tumo re n d er Scores III und IV pr äme nop ause l mit e ine r Treffsicher heit von 66 %-81% und po stmen op ausal mit eine r Treffsicherh eit von 69 %-86 % d iffe re nzie rt we rd en. Die kombinierte Beurteilun g mit der farbd op pler son ogra phischen Differ en zierung von Sco re 11I und IV e rreichte eine Treffsicherheit zw ische n 84 % und 90 % mit e iner ma ximal en Se nsitivität vo n 92 % prä-und von 89 % pc stm enopausal. Diese sequentiell kombinierte Farbdoppler sonog raphie e rg änzt und verbessert für so no morp ho logisc h nicht siche r zuzuo rd ne nde Tumoren die Tumordifferen zierung. Durch d ie Beschr änk ung de r Farbdoppler son ographi e a uf die Scor es 11I und IV (42 % der Tumoren) kann der Zeitaufwand für die Untersuch ung reduziert we rd en. (omblned Examination of Ovarlan Tumours by Tra nsvagina l Sonomorphology and (olour Doppler So nographie: Tran svag inal so nomo rp holog ie a nd colour Dop pler meas urements were o btatne d preo pe rat ively in 212 ad nexa l tumou rs: 81 prem en op au sal tumours (13 malign ant an d 68 benign) and 131 postmen op au sa l t umou rs (55 vs 76). Tumours were d ivided int o Iive d iffer ent sccre s aceor ding to their so nomo rpho logy [16]. Scores l a nd 11 a re relat ed to beni gn turnou rs. Score V repre sents typically maligna nt tum o urs. Scores 11I and IV are esseclated w ith benign end maligna nt tumou rs. If sco re l and 11 are co nsfder ed as benign and sco re 11I to V as ma ligna nt the se nst
Geburtshilfe und Frauenheilkunde, 1999
Informationen über die Infiltrationstiefe des Endometriumkarzinoms als Prognosefaktor sind für di... more Informationen über die Infiltrationstiefe des Endometriumkarzinoms als Prognosefaktor sind für die Operationsplanung wünschenswert. Die Wertigkeit der transvaginalsonographischen Bestimmung der Infiltrationstiefe beim Endometriumkarzinom wird bestimmt. Material und Methodik: 214 Patientinnen mit Endometriumkarzinom (118 Pat. vor und 96 andere Pat. nach Curettage) wurden vor der Hysterektomie untersucht. Sonographisch wurde die doppelte Endometriumdicke (E) a.p. und der Uterusdurchmesser (U) a.p. im Fundus bestimmt, und der Quotient E/U berechnet. Eine oberflächliche Infiltration des Myometriums (< = 50%) wurde bei E/U < = 0,5, eine tiefe Infiltration (> 50%) wurde bei E/U > 0,5 angenommen. Die sonographischen und die histologischen Befunde wurden verglichen. Ergebnisse: Die tiefe Myometriuminfiltration wurde mit einer Sensitivität von 92% und mit einem pos. Vorhersagewert von 74 % erfaßt. In 13 % wurde die Infiltrationstiefe vornehmlich wegen exophytischen Tumorwachstums überschätzt und in 3% unterschätzt. Die diagnostische Treffsicherheit mit 83% bzw. 85% war für beide Gruppen-vor und nach fraktionierter Abrasiogleichwertig. Schlußfolgerung: Mit weiteren Befunden wie histologischer Typ, Grading, Ploidiegrad und Rezeptorstatus unterstützt die sonographische Beurteilung der Infiltrationstiefe die Operationsplanung beim Endometriumkarzinom.
Geburtshilfe und Frauenheilkunde, 1997
Purpose: Due to their sonomorphical appearance mature cystic teratomas are often correctly diagno... more Purpose: Due to their sonomorphical appearance mature cystic teratomas are often correctly diagnosed ,,at first sight. However the complex and variable architecture of the lesions frequently leads to their classification as malignant if sonographic tumour scores are applied. Material and Methods: In the Department of Gynaecology Hospital at the University of Freiburg, we performed between 1988 and 1996 a preoperative ultrasound examination of 117 cystic teratomas in 110 patients. In 63 of these tumours Colour-Doppler sonography was also used. Results: As typical sonographic markers for the diagnosis of cystic teratomas was used the following criteria: a line pattern in the fluid phase of the tumour (seen in 62 [53%] cases); homogeneous echogenic structure (seen in 102 [82%] cases); shadowing (seen in 50 [43%] cases). 96% of the tumours showed at least one of these markers. In 62% of dermoid plugs with hairs typical sonographic criteria were present. In 25% of the cases with osseous or dental structures characteristics shadowing was observed. The ranking of the sonographic diagnosis was assessed for 754 ovarian tumours including 71 cystic teratomas. The dermoid tumours were predicted with a sensitivity of 94.3%, a specificity of 99.3%, an accuracy of 98.8% and a positive or negative predictive value of 93% and 99.3%, respectively. Using the colour Doppler technique we were able to predict the tumour status of the complex cystic teratomas correctly in 91% and 93% of the cases, respectively, using one of the following parameters: number of tumour arteries, maximum systolic velocity or sum of maximum systolic velocities. This figure dropped to 68% if minimal resistance index was used. Conclusion: Basing on typical markers, sonographic diagnosis of cystic teratomas is very reliable. Colour Doppler sonography is a useful, independent method to supplement determination of the tumour status of teratomas.
Ultraschall in der Medizin - European Journal of Ultrasound, 2008
Phantomuntersuchungen von Ultraschallqeraten zur Qualitats-verbesserung in der Mammadiagnostik Zu... more Phantomuntersuchungen von Ultraschallqeraten zur Qualitats-verbesserung in der Mammadiagnostik Zusammenfassung: Ziel: Fur die Brustd iagnostik schreibt die Gerateverordnunq de r kassenarztllchen Bund esv ereinigung die Verwendung von Schallkopfen mit einem Frequenzbereich von 5-7,5 MHz, eine Bildfeldbreit e von mindes t ens 5 cm und e inen Arbeitsb erei ch zwischen D,S und 4 cm vor. Dies laBt die Verwendung von Ultraschallqeraten zu, mit denen keine gute Brustdiagnostik rnoqllch ist , und sch llefst die Anwendung von hochauflosenden Ultrasch allqeraten mit nur 4 cm breite n Schallkopfen a us. Mit dem Ziel einer rnoqlichst objektiven Oberprufunq der Cera t e d urch sta ndar disierte Phantomuntersuchungen wurde die vorlieg ende Studie durchgefUhrt. Methode: Sechzehn Ultraschallqerate verschiedener Preiskategorien wurden qepruft, Mit alle n Geraten wu rden nach einem festgelegten Protokoll standardisierte Einstellungen an ein em Phantom (Modell 550, ATS Laboratories, Bridgeport, USA) durchgefuhrt, Beurteilt wu rde der Kontrastumfang sowie die Auflosunq in ve rschied en en Untersuchungstiefen bei lysten von 1-4 mm Durchmesser und Drahtphantomen mit definierten Abstanden von 0,5-3 mm. Ergebnisse: Die Bew ertu ng der Bilder durch 4 Untersucher zeigt e einen deutlichen lusammenhang zwischen Auflosunq und Kontrastumfang mit de r Preiskategorie. [edoch zeigten sich auch innerhalb jede r Preiskategorie groBe Unterschiede. SchluRfolgerung: Da ein e Qualitatskontrolle durch Vorgaben de r Frequenz und der Bildgeometrie nicht moqlich ist, kann e ine Verbes serung der Ultraschalldiagnostik nur durch Phantom untersuchungen sichergestellt werd en. schlusselworten Mammasonographie-Qualitatskontrolle-Testphantom-Brustkrebs Comparison of Breast Ultrasound Equipment with a Quality Assurance Phantom: Aim: According to th e Germa n guidelines for quality control of ultrasonic equipment, the following conditions are required for breast ultrasound : A t ransduce r frequency between 5-7.5 MHz and a minimum field of view of 5 ern, Satisfacto ry images must be obtained in a depth between 0.5 and 4 cm with a wide tolerance of the focal zones. This allows the use of poor quality equipment which does not produce a satisfactory image quality and it excludes a number of high frequency and high resolution transducers with a field of view below 5 cm. This study with a test phantom was pe rformed to define image quality objectively. Method: Sixteen ultr asound instruments in different price categories were used to perform standardized examinations on a breast phantom mod
Geburtshilfe und Frauenheilkunde, 1994
In 129 patients with ovarian tumours, a preoperative examination by transvaginal colour Doppler s... more In 129 patients with ovarian tumours, a preoperative examination by transvaginal colour Doppler sonography (ATL UM9 HDI) was performed. 45 were malignant and 84 benign. 46 patients were premenopausal and 83 postmenopausal. All tumour vessels were analysed by spectrum analysis. The number of tumour vessels and the lowest resistance index (RImin) and pulsatility index (PImin) of all vessels were evaluated as diagnostic criteria of the neovascularisation. Up to 19 vessels were found in 115 (89%) tumours. In benign lesions, the number of vessels was significantly lower than in malignancies (median 3 versus 9, p < 0.0001). The RImin and PImin values between benign and malignant tumours were also significantly different, independent of the menopausal status. In postmenopausal patients, the median RImin in 42 benign tumours was 0.62 (0.26-1.0) and in 41 malignancies 0.40 (0.22-0.66). The median PImin was 0.98 (0.31-5.84) in benign tumours and 0.53 (0.25-1.22) in malignant tumours. Howev...
Prostaglandins, 1984
Prostaglandin E2 (PGE2) seems to stimulate cAMP accumulation in ovaries of all mammals. While it ... more Prostaglandin E2 (PGE2) seems to stimulate cAMP accumulation in ovaries of all mammals. While it acts through specific receptors in some species, our earlier observations (1) suggest absence of PGE2 receptors in the rat ovary. In order to further substantiate this assumption we digested ovarian membranes from the bovine and the rat with various enzymes and measured cAMP after stimulation with PGE2, NaF, and hCG. Pronase, trypsin, and phospholipase C abolished cAMP accumulation completely. Neuraminidase, beta-galactosidase and phospholipase D did not interfere with cAMP formation. After treatment with phospholipase A2, PGE2-mediated cAMP accumulation was abolished in the bovine but not in the rat ovary. Formation of cAMP disappeared after hCG but not after NaF in both species. Furthermore specific binding of PGE2 could not be demonstrated in phospholipase A2-treated bovine ovaries. These findings are consistent with presence of specific PGE2 receptors in the bovine and their absence in the rat ovary.
Ultrasound in Obstetrics & Gynecology, 1994
Color Doppler and Duplex measurements were obtained in 83 (42 benign, 41 malignant) ovarian tumor... more Color Doppler and Duplex measurements were obtained in 83 (42 benign, 41 malignant) ovarian tumors in postmenopausal patients. An ATL UM9/HDI was used. The following flow criteria were analyzed: lowest resistance index (RI) and pulsatility index (PI), total number of arteries and number of central arteries and the maximum, mean and sum of systolic, end-diastolic and time-averaged maximum velocities of all intratumoral vessels. In 98% of malignant and in 85% of benign lesions, vessels were detected. All flow criteria showed highly significant differences between benign and malignant tumors (p < 0.0001). However, there was a considerable overlap between benign and malignant tumors (e.g. the median of the lowest RI was 0.62 (range 0.26-1.0) for benign and 0.40 (0.22-0.66) for malignant tumors; the median of the maximum systolic velocity was 17.5 cm/s (range 5.2-61.5 cm/s) for benign and 47.05 cm/s (14.6-105.0 cm/s) for malignant tumors). Differentiation of malignant tumors by the lowest RI and PI, number of arteries and maximum of systolic flow velocities gave a sensitivity of 77-85%, specificity of 77-83% and accuracy of 80-84%. Differentiation was superior by calculation of the maximum end-diastolic velocities and by the summation of the systolic, end-diastolic and time-averaged maximum flow velocities: sensitivity 90-9.5% specificity 83-86% and accuracy 87-91%. This study confirms that a single measurement is not sufficient for an accurate differentiation of ovarian lesions and, besides the measurement of minimum RI and PI, the measurements of flow velocities as Doppler criteria play an important role.
International Journal of Gynecology & Obstetrics, 1997
Hormone Research, 1991
A full-term 46,XY female newborn presented with respiratory failure due to a right-sided diaphrag... more A full-term 46,XY female newborn presented with respiratory failure due to a right-sided diaphragmatic hernia. During surgical repair, exploration revealed isolated dextrocardia and hypoplasia of the right lung. Neither gonads nor wolffian or müllerian structures could be palpated. Cardiac catheterization demonstrated defects of the ventricular septum, hypoplasia of the right pulmonary artery, persistence of the left vena cava superior and a patent ductus arteriosus. Anthropometric data were normal at birth, but fell below the 3rd percentile during follow-up. Body proportions displayed a predominance of the upper compared to the lower segment. Endocrine studies indicated no defect of steroid biosynthesis and no functional gonadal tissue. Using genetic analyses of various loci within the testis-determining region of the Y chromosome, a mutation could not be detected. The patient died from pneumonia at the age of 19 months. Postmortem examination confirmed the diagnosis of gonadal agenesis.
Differentiation, 1987
The testicular and ovarian protein patterns of prepubertal rats were studied by two-dimensional g... more The testicular and ovarian protein patterns of prepubertal rats were studied by two-dimensional gel electrophoresis after both in vivo and in vitro translation. Analysis of the approximately 750 polypeptide spots detectable in gonadal extracts (in vivo translated polypeptides) revealed 14 testis-specific, and 2 ovary-specific spots. Conversely, only 4 testis- and 2 ovary-specific polypeptide spots (of a total of about 600) were detected after in vitro translation of the respective polyadenylated RNAs using the reticulocyte lysate system. Simultaneous in vitro translation plus microsome-mediated cotranslational modification increased the number (of testicular spots to 8, and of ovarian spots to 3 (of a total of 600). The polypeptides synthesized in vitro were well comparable with respect to molecular weight and isoelectric point to those synthesized in vivo. Therefore, testicular polypeptide diversity is mainly the result of co/posttranslational modifications. Many of these proteins appeared to be glycosylated as indicated by their specific binding to Concanavalin A. The system used demonstrates that co/posttranslational modifications play a role in the establishment of polypeptide and thus organ diversity.
Acta Obstetricia et Gynecologica Scandinavica, 1994
Human Genetics, 1988
Poly(A)+ RNAs from male and female gonads of 20-day-old rats were translated in vitro using rabbi... more Poly(A)+ RNAs from male and female gonads of 20-day-old rats were translated in vitro using rabbit reticulocyte lysates. The resulting polypeptides were incubated with specific anti-male (anti-H-Y) antisera raised in female rats by intrasplenic immunization with syngeneic male skin. Using a second antibody, a male-specific polypeptide of molecular weight approximately 18,000 was immunoprecipitated. This male-specific polypeptide was not cotranslationally modified in vitro and appeared to be identical to serological H-Y antigen.